Free heart exams aimed at protecting high-schoolers

Friday

ROCKFORD — Every year, several young people — many times they’re athletes — shock family, friends and teammates when they die of a previously undiagnosed heart condition.

ROCKFORD — Every year, several young people — many times they’re athletes — shock family, friends and teammates when they die of a previously undiagnosed heart condition.

The Young Hearts for Life cardiac screening program of Midwest Heart Specialists at SwedishAmerican Hospital is focused primarily on trying to prevent that tragedy here by offering free electrocardiogram screening to all high school students in Winnebago and Boone counties.

“We’re looking for kids who have heart disease and may not know it,” said Dr. Kenneth Brin, a cardiologist with Midwest Heart Specialists, adding that the screenings can help detect hypertrophic cardiomyopathy, an abnormal thickening of the heart muscle that makes it harder for blood to leave the heart, forcing the heart to work harder.

First, last symptom
The first symptom of hypertrophic cardiomyopathy among many young patients is sudden collapse and possible death caused by very abnormal heart rhythms, making it a major cause of death in young athletes who seem completely healthy but die during heavy exercise.

When the heart muscle is too thick, Brin said, some of the blood being pumped from the heart into the aorta for distribution to the body may be blocked from getting out.

“When you exercise, the heart rate goes up and the force of contraction of the heart goes up,” Brin said. “There may be no obstruction of outflow at rest, but when the heart rate goes up and the blood pressure goes up, as it does when these kids are out playing sports, that can cause the obstruction, and that’s why every year you read in the papers about some child who dies on the playing field.”

He said the defect is often congenital, so when an abnormality is found screening is also recommended for the rest of the family.

Previous screenings
This fall’s screening offerings began at SwedishAmerican’s Heart Hospital in Rockford and SwedishAmerican Medical Center/Belvidere in mid-September, but a pilot project that tested 316 students was conducted at East High School in 2008, and another program tested 309 students at Belvidere High School and 295 at Belvidere North in 2009.

From those 920 tests, further testing was recommended for 19 students. About 40 students have been tested during four sessions this fall and none have been referred for further testing.

Follow-up testing, Brin said, is an echocardiogram, which is a sonogram of the heart that allows the cardiologist to see the thickening of the heart muscle. “In the general population,” he said, “an echocardiogram is an expensive test, and it’s certainly not cost-effective to do an echocardiogram on everyone.

“The good news is that, in the majority of people, the magnitude of the voltage on the EKG is proportional to the amount of heart muscle there, and when someone has the abnormality you usually have a strikingly abnormal EKG.”

About the process
The EKG screening is conducted by attaching 10 leads to the patient’s body — one on each arm; one on each leg, usually below the knee, and six on highly specific areas of the chest wall. The test itself, Brin said, takes 10 to 15 seconds.

“These record the normal electrical activity generated by the heart muscle itself,” he said. “We are not applying electricity, we are measuring the electricity that the heart is generating.”

The EKG also can detect disorders of the heart’s electrical rhythm, such as Long QT syndrome and Wolff-Parkinson White syndrome, which Brin said affect a smaller number of children and are more subtle than hypertrophic cardiomyopathy.

“What will happen with some children,” he said, “is you will get short circuits in the electrical pathway, and in many of those we’ll also pick that up. It manifests itself, generally, with very rapid heart rates.”

Although cardiologists from Midwest Heart Specialists volunteer to read and interpret the program’s EKGs, Brin said the idea is not to build up their practice. He said suspected abnormalities are referred to the child’s primary care provider and follow-up information is given to Midwest Heart Specialists only if the child or their physician
decides to do so.

“We definitely want it to be a service to the public,” he said. “The worst thing I can think of as a parent is to have a child die carrying out what should be a healthy activity.”

Staff writer Mike DeDoncker can be reached at 815-987-1382 or mdedoncker@rrstar.com.

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